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Ostomy/wound Management

Kirsten Lerum Indrebø, Gerd Karin Natvig, John Roger Andersen
Ostomy-specific adjustment may or may not predict health-related quality of life (HRQoL) and/or overall quality of life (QoL). A cross-sectional study was conducted among patients recruited from the customer registers of 8 surgical suppliers and pharmacies across Norway between November 2010 and March 2011 to determine which of the 34 items of the Ostomy Adjustment Scale (OAS) are the strongest predictors for HRQoL and overall QoL and to determine the HRQoL and overall QoL of individuals with an ostomy compared to a control group representing the general population...
October 2016: Ostomy/wound Management
Eva Carlsson, Jeanette Fingren, Anne-Marie Hallén, Charlotta Petersén, Elisabet Lindholm
Despite advancements in the creation and care of stomas, ostomy and peristomal skin complications are common immediately following surgery as well as in the months and years thereafter. A prospective study to determine the prevalence of ostomy and peristomal skin complications and the influence of ostomy configuration on such complications was conducted 1 year after ostomy surgery among all patients at a university hospital in Sweden. All participants received regular (10 to 14 days post discharge, 6 weeks, 3 months, 6 months, and 1 year post surgery) ostomy follow-up care by a wound ostomy continence (WOC) nurse...
October 2016: Ostomy/wound Management
Jill Cox, Loretta Kaes, Miguel Martinez, Daniel Moles
Skin temperature may help prospectively determine whether an area of skin discoloration will evolve into necrosis. A prospective, observational study was conducted in 7 skilled nursing facilities to determine if skin temperature measured using infrared thermography could predict the progression of discolored intact skin (blanchable erythema, Stage 1 pressure ulcer, or sus- pected deep tissue injury [sDTI]) to necrosis and to evaluate if nurses could effectively integrate thermography into the clinical setting...
October 2016: Ostomy/wound Management
Ryusuke Ae, Koki Kosami, Shinsuke Yahata
Hypergranulation tissue formation around a gastrostomy tube insertion site is a common feeding tube-related complication that affects patients who receive long-term enteral nutrition. Some clinicians recommend use of a topical corticosteroid in patients with gastrostomy tube insertion site hypergranulation. However, documentation is scant regarding appropriate treatment for this condition. This case report describes a 67-year-old bedridden man with spinocerebellar degeneration who presented with hypergranulation at the site of the gastrostomy tube, inserted 1 week earlier...
September 2016: Ostomy/wound Management
Cathy L Wogamon
The certified nursing assistant (CNA) is the caregiver who frequently identifies the first signs and symptoms of pressure ulcers (PUs) in the long-term care setting. A quality improvement effort was implemented to explore the effect of a 1-hour CNA education program about early identification, treatment, and prevention of PUs on PU knowledge, PU incidence, and PU prevention interventions, including skin checks. All 33 CNAs employed in a care facility for residents 55+ years old were invited to participate. CNA demographic and PU education variables were obtained...
September 2016: Ostomy/wound Management
Robert Dettmers, Wouter Brekelmans, Michiel Leijnen, Boudewijn van der Burg, Ewan Ritchie
Infection following orthopedic implants for bone fixation or joint replacement is always serious and may require removal of the osteosynthetic material. Negative pressure wound therapy with instillation and dwell time (NPWTi-d) is an emerging therapy for the treatment of complex wounds, including infected wounds with osteosynthetic material. The purpose of this case study was to evaluate the outcomes of 4 patients (1 man, 3 women; age range 49 to 71 years) with a postoperative wound infection (POWI) following fracture repair and internal fixation...
September 2016: Ostomy/wound Management
Hong-Lin Chen, Wang-Qin Shen, Peng Liu
Although it is among the most commonly used pressure ulcer risk assessment tools, the Braden Scale may lack strong predictive validity when used in the long-term care setting. A meta-analysis was conducted of English-language articles published in the PubMed database and Web of Science from the indices' inception through July 2015 to assess the predictive validity of the Braden Scale for pressure ulcers in long-term care residents. Search terms included pressure ulcer, pressure sore, bedsore, decubitus, long-term care, nursing home, skilled nursing facility, hospice, and Braden...
September 2016: Ostomy/wound Management
Lia van Rijswijk
No abstract text is available yet for this article.
September 2016: Ostomy/wound Management
Xi-Guang Sun, Xu Gong, Liang-Song Song, Jian-Li Cui, Xin Yu, Bin Liu, Lai-Jin Lu
Surgical repair of soft tissue defects of the knee and leg remains challenging. Using a case study approach, the anatomy of the popliteo-posterior intermediate cutaneous artery was examined, and a reverse island flap method was developed and implemented. After obtaining informed consent, 5 patients (1 woman, 4 men, age range 31 to 57 years) underwent the experimental use of a reverse island flap with a posterior thigh flap pedicled on the cutaneous vessels arising from the popliteo-posterior intermediate artery to repair soft-tissue defects of the knee and leg...
August 2016: Ostomy/wound Management
Peige Zhou, Jennifer Hrabe, John Byrn
Although loop ileostomies are created to mitigate the risk of anastomotic leaks, their reversal is associated with significant morbidity. Complications such as ileostomy site hernia and wound infections are not uncommon. A retrospective study was conducted among 176 consecutive patients who had undergone ileostomy reversal between September 2009 and November 2012 at a tertiary care teaching hospital. The main purpose of the study was to compare differences in short-term outcomes associated with hand-sewn versus stapled anastomotic techniques and purse-string versus stapled/sutured skin closure versus wounds left to heal by secondary intention...
August 2016: Ostomy/wound Management
Hiromi Nakagawa, Kaori Ohno, Shunya Ikeda, Masaki Muto
Surgical site infection (SSI) is one of the most frequent postoperative complications among patients undergoing elective colorectal surgery. A multisite, prospective cohort study was conducted to investigate whether the thickness of subcutaneous fat (TSF) influences the occurrence of SSI in patients undergoing colorectal surgery. Participants included patients scheduled to receive colorectal laparotomy for colorectal cancer and who were under the care of a wound ostomy continence nurse at 17 participating general hospitals in Japan...
August 2016: Ostomy/wound Management
Lia van Rijswijk
No abstract text is available yet for this article.
August 2016: Ostomy/wound Management
Sarwat Ahmad, Keli Turner, Paulesh Shah, Jose Diaz
Mucosal discoloration of an intestinal stoma may indicate self-limited venous congestion or necrosis necessitating operative revision. A common bedside technique to assess stoma viability is the "test tube test". A clear tube is inserted into the stoma and a hand-held light is used to assess the color of the stoma. A technique (video-assisted test tube test [VATTT]) developed by the authors utilizes a standard video bronchoscope inserted into a clear plastic blood collection tube to visually inspect and assess the mucosa...
July 2016: Ostomy/wound Management
Alexander Reinisch, Juliane Liese, Guido Woeste, Wolf Bechstein, Nils Habbe
Enteroatmospheric fistulas (EAFs) represent a challenging problem in patients with an open abdomen (OA). A retrospective, descriptive study was conducted to evaluate the effects of enteral alimentation on wound status and management and nutrition. All patients with an EAF in an OA treated between October 2012 and December 2014 at a university hospital in Germany were included without criteria for exclusions. Demographic and morbidity-related data collected included age, gender, surgeries, OA grading, body mass index (BMI), serum albumin, and serum creatinin...
July 2016: Ostomy/wound Management
Liang Liu, Julie Moody, Angela Gall
Pressure ulcers (PrUs) are among the most common secondary complications following spinal cord injury (SCI). External electrical current applied to a wound is believed to mimic the body's natural bioelectricity and to restart and stimulate endogenous electrical fields to promote wound healing. A systematic review was conducted to critically appraise and synthesize updated evidence on the impact of electrical stimulation (ES) versus standard wound care (comprising cleansing, dressing, nutrition, and debridement as necessary) and/or sham stimulation on PrU healing rates in persons with SCIs...
July 2016: Ostomy/wound Management
Catherine T Milne
Christopher Columbus initially was scorned because he believed an alternative trade route to the East existed. Like most groundbreaking exploration, Columbus' came with unintended consequences. His serendipitous findings: a new land. The consequence? Transmitting devastating illnesses with massive population loss to indigenous people.
July 2016: Ostomy/wound Management
Gina A Mackert, Christopher M Reid, Marek K Dobke, Mayer Tenenhaus
Surgeries conducted with the patient in the prone position are frequent and can be lengthy. Abdominal stomas and su- prapubic catheters require protection for the complete duration of the procedure to avoid complications such as stomal ischemia, bleeding, or mucocutaneous separation. Standard protection strategies such as pillows and wedges can eas- ily fail. In the course of managing several patients who had sustained ostomy complications following surgery in a prone position, a simple method of stoma protection was devised...
June 2016: Ostomy/wound Management
Linda L Benskin
Patients with acute wounds often delay seeking medical assistance until an incapacitating infection has developed. When such patients come for help at a remote Christian clinic in northern Ghana, West Africa, the goals of care are to resolve and prevent a return of infection, decrease pain, enable an immediate return to normal activities, and facilitate healing. Because the local protocol of care, Edinburgh University Solution of Lime (EUSOL)-soaked gauze, did not meet these goals, the author tried using a variety of donated wound dressing regimens...
June 2016: Ostomy/wound Management
Leo M Nherera, Emma Woodmansey, Paul Trueman, Garry W Gibbons
Chronic venous leg ulcers (VLUs) affect up to 1% of the adult population in the developed world and present a significant financial and resource burden to health care systems. Cadexomer iodine (CI) is an antimicrobial dressing indicated for use in chronic exuding wounds. The aim of this study was to estimate the cost utility of using CI + standard care (SC) - ie, high compression multicomponent bandaging including debridement - compared with SC alone in the management of chronic (>6 months' duration) VLUs from a payer's perspective...
June 2016: Ostomy/wound Management
Shine Stephen, Meenakshi Agnihotri, Sukhpal Kaur
Insulin has been used in wound healing to increase wound collagen, granulation tissue, wound tensile strength, and local production of insulin-like growth factors by fibroblasts. Saline is a widely used irrigating and wound dressing solution. Patients admitted to an acute care facility who had a Grade 2 or Grade 3 pressure ulcer were recruited to participate in a randomized, controlled trial to compare the effect of normal saline-impregnated gauze and insulin dressing in pressure ulcer healing. Persons with immunodeficiency, diabetes mellitus, pregnancy, osteomyelitis, and peripheral vascular illness were not eligible for the study...
June 2016: Ostomy/wound Management
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